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Catastrophic retroperitoneal hemorrhage in COVID-19 patients under anticoagulant prophylaxis

Amir Javid1, Reza Kazemi2, Mehdi Dehghani3

  • 1Department of Urology, School of Medicine, Khorshid Hospital, Isfahan University of Medical Sciences, Iran.

Urology Case Reports
|February 1, 2021
PubMed

Insights

COVID-19 patients face high thrombosis risks, leading some to suggest anticoagulants. However, a rare but deadly complication of heparin is retroperitoneal hemorrhage, requiring careful diagnosis and management.

Area of Science:

  • Internal Medicine
  • Hematology
  • Infectious Diseases

Background:

  • COVID-19 is associated with a significant risk of thrombotic events, including microvascular and macrovascular thrombosis.
  • While some researchers advocate for anticoagulant use in COVID-19 patients, particularly in intensive care units (ICUs), current clinical guidelines do not universally recommend therapeutic doses.

Observation:

  • This article highlights a less recognized complication associated with heparin administration in COVID-19 patients.
  • Retroperitoneal hemorrhage, especially when involving the psoas muscle, presents a serious risk due to potentially massive, undetected bleeding.

Findings:

  • Heparin, an anticoagulant, can lead to retroperitoneal hemorrhage in COVID-19 patients.
  • This complication may not present with obvious early warning signs, making diagnosis challenging.

Implications:

  • Increased awareness and vigilance are crucial for clinicians managing COVID-19 patients on heparin.
  • Prompt diagnosis and management of retroperitoneal hemorrhage are vital to prevent potentially fatal outcomes.

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